Professional Documents
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Labor and Delivery Topics
Labor and Delivery Topics
Chloramphenicol
Chloramphenicol is an antibiotic that’s usually given as an
injection. This drug can cause serious blood disorders and
gray baby syndrome.
Ciprofloxacin (Cipro) and levofloxacin
Ciprofloxacin (Cipro) and levofloxacin are also types of
antibiotics. These drugs could cause problems with the
baby’s muscle and skeletal growth as well as joint pain
and potential nerve damage in the mother.
Ibuprofen (Advil, Motrin)
High doses of this OTC pain reliever can cause many serious problems,
including:
miscarriage
delayed onset of labor
premature closing of the fetal ductus arteriosus, an important artery
jaundice
hemorrhaging for both mother and baby
necrotizing enterocolitis, or damage to the lining of the intestines
oligohydramnios, or low levels of amniotic fluid
fetal kernicterus, a type of brain damage
abnormal vitamin K levels
Common exercises taught in pregnancy
to strengthen perineal muscle
Squatting
Tailor sitting
Pelvic floor contractions Kegel exercises
Abdominal muscle contractions
Abdominal muscle contraction
Pelvic rocking strengthen the abdominal muscle and helps relieve backache
Methods to manage pain in childbrith
Bradley Method – pregnancy and childbirth are joyful, natural processes,
pts partner should play a role during pregnancy, labor and early newborn
period.
Dick Read’s method of fear leads to tension which leads to pain, focus on
abdominal breathing during contractions ( Grantly Dick Read)
Psychosexual method – ( Sheila Kitsinger) conscious relaxation, active
calming of the mind, while in the state of discomfort as well as level of
progressive breathing that encourage the pt to flow with rather than
struggle against contraction.
Hypnobirthing – meditative practices (Dick Read ) meditation during
pregnancy
Lamaze method psycho- prophylactic preventing pain in labor, prophylaxis by
the use of mind Psyche
Theories of labor
Uterine Stretch Theory – any hollow body organ when stretched to
capacity will necessarily contract and empty
Oxytocin Theory – labor, considered a stressful event, stimulates the
hypophysis to produce oxytocin from the posterior pituitary gland.
Oxytocin causes contraction of the smooth muscles of the body. The
fetus presses on the cervix which stimulates the release of oxytocin
from th e posterior pituitary gland
Progesterone Deprivation Theory – progesterone, being the hormone
designed to promote pregnancy, is believed to inhibit uterine motility.
Since its amount is now decreasing, uterine contractions will then occur.
Prostaglandin Theory – initiation of labor results from the
release of arachidonic acid produced by steroid action on lipid
precursors. Arachidonic acid is said to increase prostaglandin
synthesis which, in turn, increases uterine contractions
• The time and processes that occur during parturition
from the beginning of cervical dilatation to the
delivery of the placenta
• Onset of rhythmic contractions
• Relaxation of the uterine smooth muscles
• Effacement of the cervix
• Dilation or dilatation of the cervix
• Expulsion of the fetus and products of conception
from the uterus.
Signs of True Labor
a. Uterine contractions - the surest sign that
labor has begun is the initiation of effective,
productive uterine contractions.
Phases of Uterine Contraction
1. Increment or Crescendo- the time when contraction is
starting and intensity is building up. The first phase is when
during which intensity of contraction increases. This is the
longest phase.
2. Acme or Apex- the peak or highest intensity of contraction.
The height of the uterine contractions.
• 1 finger = 1.25 cm
• 2 fingers = 3 cm
• 3 fingers = 4.5 cm
• 4 fingers = 5.5 cm
• 5 fingers = 7 cm
• 6 fingers = 8.5 cm
• 7 fingers = 9.5 cm
Condition of the cervix
(hard, soft, close, open,
effacement , dilatation ,
position of the cervix)
d. Uterine change
Retraction refers to the permanent shortening of the
muscles fibers that occurs with each uterine contraction.
Retraction causes the uterus to differentiate into two
portions:
1. Upper uterine segment – becomes thick and active in
order to expel the fetus; is the only part which contracts.
2. Lower uterine segment – becomes thin-walled, supple
and passive so that the fetus can be pushed out easily.
Physiological retraction ring is formed at the boundary of the
upper and lower uterine segments. In difficult labor, when the
fetus is larger than the birth canal, the round ligaments of the
uterus become tense during dilatation and expulsion, causing
an abdominal indentation called Bandl’s pathological
retraction ring.